Varicocele is a term used to describe the dilatation of testicular veins also known as the pampiniform plexus of veins. This condition is usually seen in individuals who stand for long hours all through the day. But often this condition is seen in a wide variety of otherwise normal people with normal deskjobs. The condition mainly results due to reflux of venous flow in the internal spermatic veins leading to progressive congestion and dilatation of the testicular veins.

Patients often present with a dragging sensation in the scrotum which gets more severe after prolonged standing or at the end of the day. Some may even present with swelling. However, in todays scenario this condition is often detected in the workup for and is widely believed to be associated with it and identified as a treatable cause for infertility.

The dilated veins cause venous congestion and interfere with temperature regulation of the testes and thus cause  deleterious effects on leydig cell function and spermatogenesis. Often patients who have this condition are suggested surgical treatment which involves surgical stripping of the veins of the testes by cutting over the scrotal skin under anesthesia. This surgical treatment can at times cause damage to the testicular artery which can cause permanent damage to the testes leading to its shrinkage. Another point to note is the varicocele can recur needing further surgeries.

Interventional radiology offers a simple “no scalpel” treatment for this condition which involves a simple endovascular procedure through a small needle prick in the groin region. Through small catheters the internal spermatic vein is disconnected from the testicular veins by inserting coils. There is no open incision, no adverse effects from the coils and absolutely no damage to the testicular artery. The procedure is done under local anesthesia with a short admission and patients feel absolutely comfortable during and post treatment. It is now one of the most widely performed treatments for the treatment of varicocele in Europe . The vast majority of patients are cured of the varicocele in a single sitting and are extremely satisfied with their results.


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